Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Kaitlyn E Bogardus, PA-C

Individual provider Physician Assistant · NPI 1962978866

Kaitlyn E Bogardus, PA-C is a Physician Assistant in Roseburg, Oregon. Qualified in 2018, 8 years ago. Practices with Centennial Medical Group East LLC, a 63-clinician group and accepts Medicare assignment. Licensed in Oregon.

Years since qualifying
8
Licensed in
OR
In the registry since
2018
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

2570 NW Edenbower Blvd Ste 100
Roseburg, OR 97471-6214
Phone: (541) 677-7200
Fax: (541) 229-3309
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA190326 (OR)

Record details

NPI number1962978866
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedOctober 17, 2018
Last updated in NPPESJune 10, 2019

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Centennial Medical Group East Llc — 63 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

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